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RLE Orthopaedic Injury Management
Published in Mansoor Khan, David Nott, Fundamentals of Frontline Surgery, 2021
Jowan Penn-Barwell, Daniel Christopher Allison
In general, attempts should be made to preserve upper extremities at the most distal level possible because of their functional importance and the lack of equivalent prosthetic compensation. In a similar vein, the significantly improved function and increased prosthetic wear associated with below-knee amputation when compared with above-knee amputation should prompt the surgeon to save the knee joint when safely possible. If the patellar tendon insertion is preserved, a prosthesis can be fashioned to preserve at least some degree of knee function. Along the same lines, above-knee amputation at any level is significantly preferred over hip disarticulation, as long as it does not risk the patient’s life.
Single Best Answer Questions
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
Complications of an above-knee amputation include which of the following?Joint contractures affecting the hip jointSudek’s atrophyMyoglobinuriaNeuroma formationAmyloid deposition
Life Care Planning for the Amputee
Published in Roger O. Weed, Debra E. Berens, Life Care Planning and Case Management Handbook, 2018
He should regularly participate in an exercise program to maintain his cardiopulmonary status essential for leg prosthetic use. A YMCA or similar health club would be excellent for this type of aerobic conditioning. Swimming is also an excellent exercise regimen for a person with an above-knee amputation.
Osteosarcoma emboli presenting as chronic thromboembolic pulmonary hypertension in a child
Published in Pediatric Hematology and Oncology, 2023
Laura L. Donahoe, Serina Patel, Soumitra Tole, Alexandra P. Zorzi, Lennox Huang, Osami Honjo, Marc de Perrot
A 13-year-old girl was diagnosed with a high-grade osteosarcoma (HGOS) of the left distal femur. She did not have any lung metastases on staging imaging, and did not have any abdominal imaging performed before starting treatment. Following neoadjuvant chemotherapy (doxorubicin, cisplatin and methotrexate), she proceeded to surgery with a plan for a wide resection of the tumor. Intra-operatively, she was found to have tumor thrombus in the proximal femoral vein (confirmed on frozen section). The vein was resected at the proximal thigh and she thus required an above knee amputation. The final pathology showed that the tumor was 70% necrosis and the proximal femoral vein margin was negative. She was hemodynamically unstable in the operating room and was diagnosed post-operatively with an acute PE which likely originated from femoral and iliac deep venous thromboses. She was therapeutically anti-coagulated with low-molecular weight heparin. CT scan 6-weeks post-operatively showed improvement in the clot burden in the main PAs, with persistence of thombi in the bilateral segmental and subsegmental branches.
The relationship between self-reported physical functioning, mental health, and quality of life in Service members after combat-related lower extremity amputation
Published in Disability and Rehabilitation, 2022
Susan L. Eskridge, Jessica R. Watrous, Cameron T. McCabe, Mary C. Clouser, Michael R. Galarneau
The sample consisted of 82 WWRP participants with a major (partial foot and proximal) combat-related lower extremity amputation who reported using a prosthetic device. The majority of the sample had a unilateral below knee amputation (n = 49; 59.7%), followed by 17 (20.7%) with a unilateral above knee amputation and 16 (19.5%) with bilateral lower extremity amputations. The average age at the time of injury was 29.0 years and the average time from injury to survey was 7.7 years. The majority of the sample was male (n = 81; 98.8%), in the Army (n = 63; 76.8%), with a midlevel enlisted rank/pay grade (n = 26; 31.7%), was injured in a blast (n = 76; 92.7%), and participating in OEF at the time of injury. The only statistically significant difference in the descriptive variables across the amputation groups was ISS (mean and categorical) with the highest severity in the above knee and bilateral amputation groups (Table 1).
Functional rehabilitation of a person with transfemoral amputation through guided motor imagery: a case study
Published in Physiotherapy Theory and Practice, 2021
Rebecca Matalon, Jane E. Freund, Srikant Vallabhajosula
MI is a simple, time- and cost-effective, low-risk treatment option. The aims of this study were to identify the feasibility and efficacy of motor imagery as an intervention for a woman with an above knee amputation who used a transfemoral prosthesis and a standard walker to ambulate. Results of the current study show that without any supervised physical practice, MI could improve the participant’s gait and balance abilities enough to reduce her fall-risk as well as progress her to a less restrictive assistive device for ambulation. Upon completion of four weeks of intervention, the participant reached her goal of being able to ambulate without an assistive device with only stand-by supervision needed for safety. The use of MI as an intervention for the rehabilitation of persons with amputation must be further examined.